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" BUSINESS CERTIFICATE#05/� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE \ <br /> DATE <br /> Expiration Date: December 31, 2009 <br /> In conformity with the provisions of Chapter one hundred and ten; Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s)that a business under the title of \ (� <br /> �SYcv�v�p � . htAt�lQtJClil DBA L <br /> icn% \f >ali <br /> on is conducted at <br /> Business Location: 9`4 SlQP pte '-A �C1�1(1 G� t �Q O 3&-g9 <br /> Business Mailing Address: �.�d s-00tilq E m Q-) Fpgw Ma I (9 y5/ <br /> Business Type: _ Qy��_ J(' Business Telephone: <br /> by the following named persons: <br /> FULL NRES ENCE. <br /> Jc>r ane \aaAM� a�4 _ 3 Teal �\tCAP V eQ t (Yla` �i'aro <br /> Home Phone:' 5 3q -(Q(0 0 <br /> Wertify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state. <br /> s as required under law. <br /> >St'pxTfi9r �CL C� <br /> *S g)tature of individual By: Corporate Officer <br /> OQq- 3/-/ - 6? t5d <br /> "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or deliequency will be eubieet to license susoensioa or revocation. This request <br /> is made under the authority of Massachusetts General Law. Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts BARNSTABLE ss I I DATE�� `f �av5 <br /> � <br /> Personally appearedI__before me the below named �G Y.)n2T l, _ G I ,In0. ,,1 6, and made oath that the foregoing statement is <br /> Y <br /> ttve. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> L:77T NoTary Public/' <br /> SEAL \otan Public <br /> Commonwealth of Mussachusctts 0-&/^3 1, apU� <br /> My Commission Expires Commission Expires: <br /> March:I.?0U6 <br />